Pharm 3Rd Year Kowalski

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kowalski

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bad lecturer

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Bacteriostatic

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inhibits multiplication

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Bacteriocidal

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Lethal

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Post antibiotic effect

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continued suppression of bac growth after antimicrobial levels fall below MIC

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How long to maintain MIC with bactericidal (b-lactams)?

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Go several times MIC, then allow to fall below

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How long to maintain MIC with bacteristatic?

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stay above MIC entire time.

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why not use cidal and static drugs together?

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cidal drugs need MO to reproduce, static drugs will stop this

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Name 4 abx combos that ppt when combined

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Gent/pen
pen/chloramphen
gent/chloramphen
chloramphen/erythromycin

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Acquired resistance

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chromosomal and plasmid

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Serratia resistance

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certain cephalosporins

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Proteus resistance

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Polymyxin B

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Mycoplasma resistance

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Penicillins

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3 methods of resistance used by bacteria

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efflux pump, abx degrading enzyme, target altering enzymes

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Conjugation

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plasmid w/ resistant gene

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Transformation

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DNA w/ resistant gene

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Transduction

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Virus transfers resistant gene

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True mrsa resistant to?

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all b-lactams

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ESBL susceptible to? (2)

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cefoxitin and clavulanic acid

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Penecillins inactivated at what pH?

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less than 6

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what can inhibit activity of aminoglycosides?

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low 02 tension

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MOA for penicillins

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inhibit cell wall synthesis

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Pen G uses

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G+, some weak G- (p. multocida, and moraxella bovis), and anaerobes.

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Ampicillin/amoxicillin MOA

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inhibit cell wall synthesis

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Ampicillin/ Amoxocillin uses

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broad spectrum, (g- and g+) but not psuedomonas

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Oxacillin/dicloxacillin uses (penicillanase resitant?)

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g+, is also penicillinase resistant

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Ticarcillin MOA and uses, lactamase resistant?

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inhibit bact. cell wall synth. use for G-, especially pseudomonas. resistant only w/ clavulanic acid.

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Piperacillin/imipenem uses

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G- esp. pseudomonas

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Cephalosporins MOA, cidal static? spectrum

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inhibit cell wall synth, cidal, broad spectrum

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cefadroxil/cephalexin, gen? susceptible to?

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1st gen, susceptible to cephalosporinase

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Cefazolin gen? spectrum?

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1st, broad

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cephalosporins better against aerobic or anaerobic?

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usually aerobic

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cef....ime gen?

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3rd gen

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Ceftiofur gen? effectivness?

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3rd, not very good drug

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ceftazidime, gen? effectiveness?

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3rd, very effective, indicator of MO resitance

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Cefpodoxime effectiveness

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not a good 3rd gen

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Cephalosporins polar or non?

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polar (extracellular)

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are organisms resistant to methicillin resistant to all b-lactams?

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yes

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cephalosporins effective against enterococcus?

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no

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Bacitracin, MOA, cidal/static? spectrum, systemic or topical?

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inhibits cell wall synthesis, cidal, narrow(G+ cocci), use topically

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Tetracycline MOA, cidal/static, spectrum,

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inhibit protein synth binds to 30s ribosom, static, broad. DO SUSCEPTIBILITY TEST

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Doxycycline MOA, spectrum, side effect in cats?

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inbitis protein synth, broad, esoph stricture in cats.

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Tetracycline affected by? good in what organ system? side effects in young? side effects in horses

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can be chelated, conc in bone, discolor teeth, deposited in bone irreversibly, cardiotoxic IV in horses

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Chloramphenicol MOA, static/cidal, spectrum, aerobic anaearobic? dose for cats?

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inhibits protein synth via 50s ribosome, static, broad but not psuedomonas, anaerobic, dose less in cats due to no conjugation

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Florfenicol MOA, spectrum, difference from chloramphen

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50s ribosome, broad, diff is OH group minimizes inactivation.

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Erythromycin MOA, static/cidal, spectrum

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binds to 50s ribosome, static, G+and campy

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Tylosin MOA, spectrum,

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inhibits 50s ribosome, G+

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Azithromycin MOA, spectrum, compare to erythromycin

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inhibits 50s ribosome, G+, better penetration than erythromycin

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Tulathromycin MOA, spectrum, compare to erythromycin

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inhibits 50s ribosome, G+, better penetration than erythromycin

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Macrolides lipid or water soluble? precautions for route

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lipid, degraded by acid (enteric coat)

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Rhodococcus equi tx

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erythromycin/rifampin combo

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Lincomycin/clindamycin MOA, spectrum

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50s ribosome inhibitors, G+ and anaerobes mycoplasm

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Tilmicosin MOA, spectrum, use, effects in swine

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50s inbitor, G+/mycoplasm, respiratory infection, cardiotoxic,

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Pirlimycin MOA, spectrum, use

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50s ribosome inhibitor, G+/mycoplasm, mastitis

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Aminoglycosides, MOA, spectrum, cidal/static

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irreversible binding of mRNA to 30s ribosome, G-, inective against anaerobes, cidal

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Gentamycin MOA, spectrum

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irreversible binding of mRNA to 30s ribosome, G-, 75% pseudomonas susceptible

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Amikacin, MOA, Spectrum

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irreversible binding of mRNA to 30s ribosome, G-, psuedomonas

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Noemycin moa, spectrum, route?

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irreversible binding of mRNA to 30s ribosome, G-, marginal psuedomonas, topical

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Tobramycin MOA, spectrum, route?

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irreversible binding of mRNA to 30s ribosome, G-, good for psuedomonas, topical

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Aminoglycosides polar or non? cautions:

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polar, impair renal fxn, ototoxic

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amikacin use

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last resort, not much resistance

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Neomycin route(s)

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topical, or oral (campy, salmonella)

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Dose of aminoglycosides in obese?

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use less-doesnt penetrate lipids well

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Why might aminoglycoside not work?

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lack of transport, lack of binding site, cant penetrate porin

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Polymyxins MOA, spectrum, cidal/static, route

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disrupt active transport and permeability, cidal, G-, topical

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proteus is always resitant to?

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Polymyxin

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Bacitracin MOA, Spectrum, route

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inhibit cell all synthesis, G+, topical only

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Sulfonamides MOA, static/cidal, spectrum,

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antagonize PABA which is needed to produce folic acid, mainly static, but can be cidal, broad not great for anaerobes

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Sulfa for burn victims...also treats what bact?

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psuedomonas, silver sulfadiazine

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How to treat nocardia

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sulfadiazine or potentiated sulfa

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Sulfas work great in what body site? (2)

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csf and urine

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Trimethoprim (TMP) MOA, class, duration

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intermediary metabolism, potentiated sulfa, short duration

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Potentiatted sulfas work by?

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synergy

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Sulfonamides :interaction, adverse rxn

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mimick hypothryoid, dobermans and can cause immune mediated polyarthritis/aplastic anemia

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Nitrofurans, MOA, spectrum, warnings, cidal/static, indications

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unknown but maybe interfere w/ production of acetyl coa, broad (not psuedomonas), DO NOT USE IN FOOD ANIMAL, cidal, protein bound, so not systemic, use for UTI

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Fluroquinolones MOA, spectrum, cidal/static

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interfere with DNA gyrase, broad aerobic, cidal

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Rifampin MOA, spectrum, cidal/static, penetration, use alone or in combo?

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inhibits RNA polymerase, G+ (R. equi), cidal, penetrates abcess and tissues well, combo

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Enrofloxacin metabolite, penetration, tissue of choice, cautions

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20% cipro, achieves levels higher in tissue than plasma, UTI, retinal degen in cats,

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Novobiocin MOA cidal/static, spectrum, tissue

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inhibits nucleic acid synth, cidal, G+, mammary

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Enrofloxacin and psuedomonas:

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susceptibility test first

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Metronidazole MOA, cidal/static, spectrum, cautions

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affects dna synthesis, cidal, anaerobic bact, protozoa, DO NOT USE IN FOOD ANIMALS

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Enrofloxacin resistance mechanism

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probably mutation

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list of do not use in food animal drugs

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nitrofuran, metronidazole, chloramphenicol

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Vancomycin MOA, spectrum

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inhibits cell wall synth, G+

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Amphotericin MOA, route, uses

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assoc. w/ ergosterol, IV, histo, blasto, cocccidio

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Nystatin (panalog), route, indications, MOA

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ergosterol, topical, M. pachydermatis, candida

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example of 2 imidazoles

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miconazole, clotrimazole

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imidazoles spectrum (4), route

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candida, malassezia, dermatophytes, aspergillus, topically

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thiabendazoles, indications, route

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molds/dermatophytes, topical

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Triazoles (4)

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ketoconazole, itraconazole, Fluconazole, voriconazole

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ketoconazole (nizoral)spectrum,lipophilic or phobic?

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dimorphic fungi, yeasts, philic

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Itraconazole spectrum, tissues, lipophilic or phobic?

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dimorphic fungi, yeast, skin and nails then binds to proteins and slowly moves out, philic

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Fluconazole spectrum, lipophilic or phobic?

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crypto, yeasts, NOT MOLD, PHOBIC

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Voriconazole spectrum

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molds, dimorphic fungi, aspergilus

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Flucytosine spectrum, MOA, lipophilic/phobic

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crypto, protein synth inhibitor by replacing uracil, lipophobic

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Terbinafine, MOA, tissues,

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dermatophytes candida, Ergosterol, nails, sebum , skin, hair

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Griseofulvin spectrum, MOA, lipophilic/phobic

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dermatophytes, inhibits mitotic spindles, lipohilic

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Tolnaftate spectrum,

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dermatophytes

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Iodides spectrum side effects

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sportrichosis, dermal signs/hair loss